人工智能辅助诊断系统在肺结节检测及良恶性判断中的应用价值  

Artificial Intelligence-assisted Diagnosis in Detecting Lung Nodules and Differentiating Benign from Malignant Nodules

作　　者：苏寅晨 张晓琴 SU Yinchen;ZHANG Xiaoqin(Inner Mongolia Medical University,Hohhot 010110,China;Department of Imaging Medicine,Inner Mongolia Autonomous Region People's Hospital,Hohhot 010017,China)

机构地区：[1]内蒙古医科大学,呼和浩特010110 [2]内蒙古自治区人民医院影像医学科,呼和浩特010017

出　　处：《CT理论与应用研究（中英文）》2024年第3期325-331,共7页Computerized Tomography Theory and Applications

摘　　要：目的:探讨人工智能辅助诊断系统在肺结节的检测及良恶性判断中的应用价值。方法:选择2022年3月至2023年3月行胸部CT检查,跟踪随访明确肺结节病理结果的患者作为研究对象,并制定真阳性结节标准。比较AI软件与影像医师对真阳性结节的检出价值及结节良恶性的判断价值。结果:113名患者中AI软件检出1337个结节,医师检出774个结节,经验证共存在1079个真阳性结节。AI软件对于真阳性结节的检出率(98.98%)高于医师(71.27%),漏检率(1.02%)较医师(28.27%)低,误检率(23.91%)较医师(0.46%)高。AI软件对直径<5 mm及5~10 mm真阳性结节的检出率(98.69%,100.00%)均高于医师(60.59%,80.25%);对于直径>10 mm真阳性结节的检出率(98.08%)稍高于医师(94.87%),但差异不具有统计学意义,需进一步选取临床大样本验证。AI软件对磨玻璃、实性、混合磨玻璃及钙化结节的检出率(98.47%,98.79%,100.00%,100.00%)均高于医师(75.52%,68.02%,72.73%,84.66%)。在结节良恶性判断方面,113名患者中共有115个结节经病理检查确诊,医师对结节良恶性判断的灵敏度(97.47%)、特异度(80.56%)、准确度(92.17%)均较AI(93.67%,66.67%,85.22%)高,但灵敏度和特异度的差异不具有统计学意义,可能与样本选择偏差有关;AI与病理结果对照取得了高度一致性(Kappa值为0.637),医师实现了几乎完全一致(Kappa值为0.811)。结论:AI辅助诊断对肺结节有较高的检出率,能大大降低漏检率,但误检率也随之上升;在肺结节良恶性鉴别中可为临床诊断提供辅助参考,但其准确性无法取代影像医师。Objective:To investigate the applicability of artificial intelligence-assisted diagnosis system in detecting pulmonary nodules and distinguishing benign and malignant nodules.Methods:Patients who underwent chest computed tomography(CT)from March 2022 to March 2023 at our hospital and who were followed-up with CT-guided needle biopsy or surgical procedures to determine the pathological nature were included in the study.The criteria for identifying true positive nodules were identified on the basis of the image analysis based on AI and two radiologists who identified suspicious lesions and referred to multiplanar reconstruction and three-dimensional reconstruction and other images to determine the existence of lung nodules;the findings from the two reports were consistent.The detection value of benign and malignant nodules obtained from AI and radiologists for true-positive nodules were compared.Results:AI detected 1337 nodules in 113 patients;radiologists detected 774 nodules,and verified the coexistence of 1079 true-positive nodules.The detection rate of true positive nodules(98.98%)by AI software was higher than that of radiologists(71.27%),the missed diagnosis rate(1.02%)was lower than that of radiologists(28.27%),and the misdiagnosis rate(23.91%)was higher than that of radiologists(0.46%).The true positive detection rate of AI for nodules with diameters<5 and 5~10 mm(98.69%;100.00%)was higher than that of radiologists(60.59%;80.25%);the detection rate of true positive nodules with diameters>10 mm(98.08%)was slightly higher than that of radiologists(94.87%),but the difference was not statistically significant.Further large-sample clinical studies are needed to verify our findings.The detection rates of mixed ground-glass and calcified nodules(98.47%;98.79%;100.00%;100.00%)from AI imaging were higher than those of the radiologists(75.52%;68.02%;72.73%;84.66%).In the identification of benign and malignant nodules,115 nodules in 113 patients were confirmed by pathological examination,of which 98 nodules were obtai

关 键 词：人工智能 CT 肺结节 应用价值 

分 类 号：TP18[自动化与计算机技术—控制理论与控制工程] R814[自动化与计算机技术—控制科学与工程] R563[医药卫生—影像医学与核医学]